Antibody responses to gut bacteria in ankylosing spondylitis, rheumatoid arthritis, Crohn's disease and ulcerative colitis

BackgroundImmunogenicity of tumor necrosis factor alpha inhibitors (TNFis) has been recognized as an important problem that may cause loss of efficacy and adverse events such as infusion reactions. TNFis are being increasingly used among patients with Behçet syndrome (BS) and scarce data exist on this topic.ObjectiveWe aimed to investigate the prevalence of anti-infliximab (IFX) antibodies in patients with Behçet syndrome together with suitable controls.MethodsWe collected serum samples from 66 consecutive Behçet syndrome patients (51 M, 15 F, mean age 37 ± 9 years) who were treated with IFX. Additionally, similarly treated 27 rheumatoid arthritis, 53 ankylosing spondylitis, 25 Crohn’s disease patients, and 31 healthy subjects were included as controls. Samples were collected just before an infusion, stored at −80°C until analysis, and serum IFX trough levels and anti-IFX antibodies were measured by ELISA. We used a cut-off value of 1 μg/ml for serum IFX trough level, extrapolating from rheumatoid arthritis studies.ResultsAnti-IFX antibodies were detected in four (6%) Behçet syndrome, five (18.5%) rheumatoid arthritis, three (12%) Crohn’s disease, and one (2%) ankylosing spondylitis patient. The median serum IFX trough level was significantly lower in patients with anti-IFX antibodies compared to those without antibodies [2.32 (IQR: 0.6–3.6) vs. 3.35 (IQR: 1.63–5.6); p = 0.019]. The serum IFX trough level was lower than the cut-off value in 6/13 (46%) patients with anti-IFX antibodies and in 25/158 (16%) patients without anti-IFX antibodies (p = 0.015). Among the four Behçet syndrome patients with anti-IFX antibodies, two experienced relapses and two had infusion reactions.ConclusionsImmunogenicity does not seem to be a frequent problem in Behçet syndrome patients treated with IFX, but may be associated with relapses and infusion reactions, when present.

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Profile of Anti-Microbiota Antibody Responses in Crohn's Disease and Ulcerative Colitis

Gastroenterology ◽

10.1016/s0016-5085(11)63511-7 ◽

2011 ◽

Vol 140 (5) ◽

pp. S-846

Author(s):

Nicola Patuto ◽

Emma Slack ◽

Bruno Strebel ◽

Maria L. Balmer ◽

Philipp Schuetz ◽

...

Keyword(s):

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Antibody Responses

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Infliximab associated serious adverse drug events are lower in psoriasis patients than in ulcerative colitis, Crohn's disease, and rheumatoid arthritis

Journal of the American Academy of Dermatology ◽

10.1016/j.jaad.2006.10.838 ◽

2007 ◽

Vol 56 (2) ◽

pp. AB184

Keyword(s):

Rheumatoid Arthritis ◽

Ulcerative Colitis ◽

Crohn’S Disease ◽

Crohn's Disease ◽

Adverse Drug Events

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Off-Label Dermatologic Uses of Anti-TNF-a Therapies

Journal of Cutaneous Medicine and Surgery ◽

10.1177/120347540500900605 ◽

2005 ◽

Vol 9 (6) ◽

pp. 296-302 ◽

Cited By ~ 6

Author(s):

Andrew F. Alexis ◽

Bruce E. Strober

Keyword(s):

Rheumatoid Arthritis ◽

Crohn’S Disease ◽

Psoriatic Arthritis ◽

Ankylosing Spondylitis ◽

Crohn's Disease ◽

Case Series ◽

Eosinophilic Fasciitis ◽

Tnf Inhibitor ◽

Off Label ◽

The U.S

Background: Tumor necrosis factor-alpha (TNF-a) is a proinflammatory cytokine that plays an immunomodulatory role in a variety of systemic and dermatologic diseases. Currently, three anti-TNF-a drugs are available in North America— infliximab (approved in the U.S. for the treatment of rheumatoid arthritis, Crohn's disease, ankylosing spondylitis, ulcerative colitis, and psoriatic arthritis), etanercept (approved in the U.S. for the treatment of rheumatoid arthritis, juvenile rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and psoriasis), and adalimumab (approved for the treatment of rheumatoid arthritis and psoriatic arthritis). Objective: To review the current literature supporting alternative (and currently off-label) dermatologic uses of TNF-a antagonists. Methods: A MEDLINE search (1966-March 2005) was conducted using the keywords “infliximab,” “etanercept,” “adalimumab,” “TNF inhibitors,” and “off-label” to identify published reports of off-label dermatologic uses of TNF-a inhibitors. Results: Anti-TNF-a therapies have been reported in the following dermatologic diseases: sarcoidosis, hidradenitis suppuritiva, cicatricial pemphigoid, Behçet's disease, pyoderma gangrenosum, multicentric reticulohistiocytosis, apthous stomatitis, Sneddon-Wilkinson disease, SAPHO syndrome, pityriasis rubra pilaris, eosinophilic fasciitis, Panniculitis, Crohn's disease, necrobiosis lipoidica diabeticorum, dermatomyositis, and scleroderma. The vast majority of these reports are in the form of individual case reports and small case series. Only two published randomized controlled trials involving the off-label use of a TNF inhibitor were found. Conclusions: A growing number of published reports suggest that anti-TNF-a therapies may be effective in the treatment of numerous inflammatory skin diseases outside their currently approved indications.

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